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Michele and Bob Jim Duggar, the couple famous for having lots of kids and from their reality show 19 Kids and Counting, are expecting again. The 45 year old mother of 19's latest pregnancy has caused quite a controversy. It's not just the fact that most people are simply shocked at the thought of having 20 children, but also that Michelle's last pregnancy ended with baby Josie being delivered very prematurely.

Having "only" five kids gives a woman the label of grand multipara, and this is something that OBGYNs classify as a high risk pregnancy. There are plenty of women who give birth to many more children without complications, but the risk increases with each pregnancy, and as a woman gets older. The uterus, which is a muscle, stretches each time a woman is pregnant, and will gradually lose some of its elasticity. Postpartum hemorrhage is one of the major concerns for women who have lots of children.

The Duggars are Baptists and happy to have as many children as God blesses them with. They also already have grandkids (see Duggars expecting second grandchild) But, during Michelle's last pregnancy, new reports stated that she suffered from the life-threatening pregnancy complication preeclampsia, and baby Josie was born more than three months prematurely weighing only one pound and six ounces. Everyone seems to have their own opinion on the latest Duggar pregnancy, including doctors.

Dr Philip Darney, director of the Bixby Center for Global Reproductive Health at the University of California, San Francisco, told Fox News: "The more pregnancies one has, the greater the risk of a bad outcome that could leave the children that are already born without a mother."

My guess is that Michelle Duggar has enough on her mind with all that judging going on. I hope that she has a healthy pregnancy, which she'll be able to carry to term. She has certainly already surpassed expectations, and can easily be called amazing.

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